Summary: This report reviews available statistics regarding reasons given for obtaining abortions in the United States, including surveys by the Alan Guttmacher Institute and data from seven state health/statistics agencies that report relevant statistics (Arizona, Florida, Louisiana, Minnesota, Nebraska, South Dakota, and Utah). The official data imply that AGI claims regarding "hard case" abortions are inflated by roughly a factor of three. Actual percentage of U.S. abortions in "hard cases" are estimated as follows: in cases of rape, 0.3%; in cases of incest, 0.03%; in cases of risk to maternal life, 0.1%; in cases of risk to maternal health, 0.8%; and in cases of fetal health issues, 0.5%. About 98.3% of abortions in the United States are elective, including socio-economic reasons or for birth control. This includes perhaps 30% for primarily economic reasons and possibly 0.1% each for sex selection and selective reduction of multifetal pregnancies.
Introduction: The reasons given for having abortions are relevant to the policy debate on the abortion issue. In many countries, abortions are permissible only for limited reasons. In the United States, abortion on demand and for any reason is the existing state of law (with a few limitations in some states). As debate continues regarding this practice, advocates of unrestrained abortion often cite the "hard cases"--cases of rape, incest, life or health of the mother or baby--in defending access to abortion. It is widely acknowledged that such cases are rare; however, available data suggest that some commonly cited figures are exaggerated.
Further, the prevailing preferences of the American electorate are often cited in regard to U.S. abortion legislation. Some will claim, for example, that most Americans support legal abortion. While majority opinion is irrelevant to issues of constitutionally stipulated human rights (regardless of what position on abortion one thinks is the one consistent with human rights), the claim itself is a half-truth. Most Americans would oppose banning abortions for hard cases, but at the same time most Americans would support limits on elective abortions, e.g. abortions for convenience or for sex selection.
This article will review some available data that addresses the reasons cited for abortions in the United States. First, survey-based data from the Alan Guttmacher Institute is reviewed, as it represented the most frequently cited data. Two specific issues, abortions in cases of rape and abortions for sex selection, are examined. Next, data on reasons for abortions from state agencies and other official sources is presented; this data represents an often overlooked statistical resource on the issue. Although reasons for "partial-birth" abortion are fundamentally different than those for abortions in general, available data is examined as well. Finally, the available statistical data is used to quantify reasons for abortions in the United States.
AGI studies: The Alan Guttmacher Institute (AGI) has published several studies examining reasons for abortions in the United States. Two studies conducted in 1987 and 2004 surveyed a total of 3,900 women obtaining abortions, of whom 2,981 provided information. A third survey conducted in 2000-2001 surveyed abortion seekers about contraceptive use; this study provided some limited data relating to reasons for abortions for 10,683 women. These studies are discussed in chronological order.
The 1987 AGI study (published in 1988) surveyed 1,900 women who had abortions. The results of this survey are among the most commonly cited figures regarding reasons for abortions in the United States. The 1,773 women who responded gave an average of 3.7 reasons from the list, with the most important reasons cited by respondents tabulated below. It should be noted that only rounded percentages, not raw numbers, were provided; an AGI review article in 1998  cited the 1988 study but gave slightly different figures, shown below in parenthesis (the parenthetical figure for rape and incest is a range of uncertainty derived from breakdowns in the 1988 report).
|reason||% of abortions|
|rape or incest||1||(0.4-1.3)|
|mother has health problems||3||(2.8)|
|possible fetal health problems||3||(3.3)|
|unready for responsibility||21|
|is too immature or young to have child||11||(12.2)|
|woman's parents want her to have abortion||<0.5|
|has problems with relationship or wants to avoid single parenthood||12||(14.1)|
|husband or partner wants her to have abortion||1|
|has all the children she wanted or all children are grown||8||(7.9)|
|can't afford baby now||21||(21.3)|
|concerned about how having baby would change her life||16|
|doesn't want others to know she had relations or is pregnant||1|
Another AGI study, conducted in 2000-2001, examined contraceptive use but provides some information relating to reasons for abortion. Some data from this survey of 10,683 women obtaining abortions is given below:
|reason or situation||number||% of abortions|
|not using contraception||4,957||46.40|
|forced to have relations||~64||0.6|
|contraceptive failed despite proper use||~1,808||16.9|
In this survey, 0.6% reported being forced to have relations (although a figure as high as 0.8% is possible depending on data breakdown). It is also interesting to note that 17% of abortions were for pregnancies following "proper" use of contraception. This would tend to undermine the claims regarding the efficacy of contraception methods, something highly promoted by groups such as Planned Parenthood.
An AGI study published in 2005  was modeled after the 1987 study, providing an update to that work. This survey was conducted from December 2003 to March 2004; of approximately 2,000 women obtaining abortions who were surveyed, 1,209 completed questionnaires. As with the 1987, only rounded percentages as opposed to raw numbers were reported. Again, respondents could give multiple reasons, and the median number of reasons given was four. The table below gives reported percentages for the most important reason and for all reasons cited.
|reason||% of abortions,|
most important reason
|% of abortions,|
|mother has health problems||4||(12)|
|possible fetal health problems||3||(13)|
|is too immature or young to have child||7||(22)|
|woman's parents want her to have abortion||<0.5||(6)|
|has problems with relationship or wants to avoid single parenthood||8||(48)|
|husband or partner wants her to have abortion||<0.5||(14)|
|has all the children she wanted or all children are grown||19||(38)|
|can't afford baby now||23||(73)|
|--student or planning to study||(34)|
|--can't afford baby and child care||(28)|
|--can't afford basic life needs||(23)|
|--can't leave job to care for baby||(21)|
|--would have to find new place to live||(19)|
|--not enough support from husband/partner||(14)|
|--currently on welfare or public assistance||(8)|
|concerned about how having baby would change her life||(74)|
|--would interfere with education plans||4||(38)|
|--would interfere with career plans||(38)|
|--would interfere with care of children or dependents||(32)|
|doesn't want others to know she had relations or is pregnant||<0.5||(25)|
Recent AGI literature has given figures of abortions following rape or incest. For example, an April 2005 information sheet  states that about 13,000 women have abortions following rape or incest. This is 1.0% of AGI-estimated annual abortions in 2000-2002. This figure appears to be derived from the 1987 survey percentage (or from preliminary results of the 2004 survey).
Issues with rape-related statistics: The AGI-based figure of 1% of abortions for cases of rape or incest is widely cited. However, it is the product of a limited survey by an organization with a stated objective of advocating unlimited access to abortion services. It is thus desirable to seek an independent source of such figures, such as that provided by the state reported statistics reviewed below. Evaluating this claim also involves issues of reliability of rape-related statistics.
If the AGI figure for 1987 is correct, it would imply that 15,600 abortions in 1987 were for such cases. Since the FBI only reported 91,111 forcible rapes in the U.S. in that year, this would imply that one out of six rapes resulted in pregnancy. This is a higher fraction than appears to be supported by medical research--although this ratio does not yet account for underreporting of rapes.
According to the FBI, reported annual numbers of forcible rapes in the United States rose from about 90,000 in the mid 1980s to a peak of 109,062 in 1992, then dropped to about 89,000-95,000 for the years 1998-2009 and to 84,767 in 2010 . A 2012 Department of Justice report  estimated rates of crime underreporting for 1994-2010; the fraction of unreported rapes and sexual assaults for this period ranged from 44% to 77%, or an average of 64%. These figures are not strictly applicable to forcible rape but provide a useful estimate. Further, these figures carry a high degree of uncertainty, as they imply annual figures for rapes (reported plus unreported) ranging from 168,000 to 424,000 over this period, with large year-to-year variability. Nonetheless, these figures may be used to estimate average annual figures for 1994-2010 as 93,000 reported forcible rapes and 184,000 more unreported, or 277,000 total per year.
Some sources claim much larger unreported numbers. Stewart and Trussell  cite 333,000 rapes and sexual assaults reported in 1998, and additionally cite a National Women's Study which claimed 683,000 rapes in 1992. The latter figure would mean 5.3 unreported rapes for every reported rape. The wide range in estimates of unreported rapes is evidence of the problem of quantifying these figures.
Another issue is the frequency of rape-related pregnancy. Some sources claim very low frequencies, citing medical studies, and conclude that the total number of pregnancies resulting from rape each year is on the order of 200-500. Others obtain somewhat higher frequencies. Holmes et al.  surveyed 4,008 women and found a rate of pregnancy following rape of 5%. Additionally, of 34 cases of pregnancy after rape, they found 17 (50%) had an abortion, 11 (32%) kept the baby, 2 (6%) gave the baby up for adoption, and 4 (12%) miscarried.
Taking the 2005-2010 average annual reported rapes of 90,000 per year and assuming 5% result in pregnancy and 50% of these are aborted, this implies 4,500 pregnancies per year following rape of which 2,250 are aborted. The most extreme claimed rates of underreporting are necessary to bring this in line with AGI's claim of 13,000 rape-related abortions per year. Even higher levels of rape-related pregnancies have been claimed: Stewart and Trussell  cite the previously mentioned National Women's Study claiming 32,000 per year in 1992, and this figure is repeated by Holmes et al.  and by an AGI article in 2002 . Stewart and Trussell extrapolate this to 25,000 per year in 1998 merely by considering lower crime rates. These higher rates, while somewhat dubious, are required to support the AGI claim of 1% of abortions for rape.
However, adopting the DOJ underreporting figures, average implied annual figures for 2005-2010 are as follows:
Note that these statistical approaches carry large uncertainties. Circumstances surrounding both rape and abortion prompt degrees of both underreporting and inaccurate reporting. Regardless of the acutal rate of reporting, it is widely agreed that large numbers of rapes go unreported to authorities. Available information on reasons for abortion are generally self-reported by the abortion seeker and thus not verifiable. Some women seeking abortion might conceal rape as the actual reason. Alternately, some women might falsely claim rape as a reason, for example to obtain funding for an abortion (this appears to be an issue with federally funded abortions as discussed below). Thus, rape-related abortion data interpretation is hampered by the particularly traumatic circumstances of such cases. Nonetheless, it will be seen below that the larger sampling in states that report figures for rape-related abortions give consistent results, supporting the reasoning for lower figures than the AGI figures.
Abortions for sex selection: While not a major issue in the United States, abortions for the purpose of selecting the sex of the child are quite common in Asia, where they are generally used to abort female fetuses. Several Asian countries, including the People's Republic of China, India, and South Korea, are beginning to show significant demographic impacts resulting from such practices. India and the PRC have both been compelled to legislate against sex-selection abortions despite their otherwise broad support of abortion practice.
Regarding the United States, in 1998 JAMA published a study reporting a 0.2% decrease in the ratio of male to female live births from 1970 to 1990. The authors of the 1998 study discuss a variety of health factors that could influence this ratio. Data from the CDC in 2002 suggested that the decrease in the male/female birth ratio was 0.3% from 1970 to 2000. In 2005 the CDC completed a more detailed analysis of trends in the U.S. male/female birth ratio. The authors identified several up or down trends in the ratio between 1940 and 2002, including a 0.6% decline in the male/female birth ratio from 1970 to 2002. They analyzed possible factors (age of mother, birth order, ethnicity) and noted additional parental/environmental characteristics that naturally influence the birth ratio. They did note that family preference can affect the birth ratio (although they did not explicitly point out that this is via such means as sex selection abortions) and that this does affect it in some countries, but do not report any indication that it is a factor in the United States. The historical variation in U.S. male/female birth ratio is within the range observed in connection to biological influences (e.g. parental/environmental).
Nonetheless, of reported trends in male/female birth ratio by ethnic group, the 2005 CDC study finds the greatest increase from 1970 to 2002 among children of Chinese and Japanese ethnicity: a trend of an increase of 0.022 for Chinese and 0.013 Japanese children, respectively. The result is that births of Chinese ethnicity have the highest average male/female ratio in 1998-2002, 1.076 versus the national average of 1.048.
The overall change in the male/female birth ratio from 1970 to 2002 represents about 13,000 fewer annual male births by 2002, which would correspond to about 1% of abortions. Still, this is too small a change in sex ratio to be distinguished among other potential causes for the population at large. Some observers suggest that this is an issue in some ethnic groups. Were the change in birth ratio among Asian Americans to be attributed to abortions, it would represent on the order of 1,000-2,000 abortions per year, or about 0.1% of abortions. This may be considered an upper limit.
Abortions for ART selective reduction: In connection with the increased use of assisted reproductive technologies (ART) is increased use of abortion to selectively reduce the number of fetuses in multifetal pregnancies. ART births represented 1.65% of US live births in 2012 . Evans et al.  discuss relative changes in the number of twin and higher-multiple pregnancies from 1989 to 2011. Much of these changes are attributed to increased use of ART and changes in plurality of ART births, both due to selection reduction abortions and to changes in numbers of ART-implanted embryos . The post-2003 reductions in multiple births reported by  correspond to differences of 3,500-7,000 fetuses per year, which is partly attributable to selective reductions. These figures then suggest upper limits of 0.3-0.7% on selective reduction abortions among all abortions. Stone et al.  report on 1,000 selective reduction abortions at a single center from 1999-2006, about 120/year, relative to 2,000 annual in-vitro fertilization cycles at the same center . Such figures scaled to the annual number of ART pregnancies implies selective reduction abortions are about 0.4% of all abortions.
State statistics: In the United States, limited official statistics are available. Abortion reporting varies significantly from state to state. Seven states report data on the reasons given for obtaining abortions (with varying definitions and levels of detail). These figures are self-reported by women obtaining abortions, as in the case of the AGI studies discussed above. However, they are independent data and involve a larger sample. Below are results for these states--Arizona, Florida, Louisiana, Minnesota, Nebraska, South Dakota, and Utah:
|% of abortions||% of abortions,|
REASONS GIVEN FOR ABORTIONS: FLORIDA, 1998-2008 
|reason||1998||1999||2000||2001||2002||2003||2004||2005||2006||2007||Jan-Jun 2008||total Jan 1998-|
|% of abortions||% of abortions,|
REASONS GIVEN FOR ABORTIONS: FLORIDA, 2008-2009 
|reason||Jul-Dec 2008||2009||total Jun 2008-|
|% of abortions|
|life of mother||21||58||79||0.06|
|physical health of mother||60||139||199||0.16|
|emotional/psychological health of mother||41||131||172||0.14|
|serious fetal defect/deformity/abnormality||271||517||788||0.64|
REASONS GIVEN FOR ABORTIONS: LOUISIANA, 1996-2012 
|% of abortions||% of abortions,|
|rape or incest||4||4||3||1||1||1||0||0||1||1||0||0||0||0||2||14||23||55||0.03||0.31|
|risk of fetal deformity||9||21||7||9||13||10||7||0||2||5||2||1||0||2||1||53||54||196||0.12||1.11|
REASONS GIVEN FOR ABORTIONS: MINNESOTA, 1998-2014 
|% of abortions||% of abortions,|
|pregnancy will impair major bodily function||22||49||44||34||30||27||31||20||30||21||34||42||29||46||43||41||37||580||0.28||0.37|
|does not want children now||1,215||4,449||5,618||6,482||6,080||5,655||5,576||8,281||9,598||10,190||9,368||7,881||7,284||7,431||7,191||6,852||6,998||116,149||55.52||73.28|
|--to pursue educational goals||551||754||872||419||500||270||838||616||886||691||609||358||501||83||15||15||7,978||3.81||5.03|
|--already have enough children||362||406||369||368||351||230||434||485||341||346||383||567||333||79||40||38||5,132||2.45||3.24|
REASONS GIVEN FOR ABORTIONS: NEBRASKA, 2000-2014 
|% of abortions||% of abortions,|
|maternal life endangered||2||6||1||6||8||3||1||2||1||3||14||3||8||16||7||81||0.18||0.18|
|maternal physical health||33||48||45||160||85||67||45||2||8||33||67||17||20||44||30||704||1.56||1.58|
|no contraception used||808||850||766||1,185||850||831||852||1,113||1,573||1,343||1,109||1,232||954||1,187||811||15,464||34.34||34.63|
REASONS GIVEN FOR ABORTIONS: SOUTH DAKOTA, 1999-2014 
|% of abortions||% of abortions,|
|rape or incest||12||16||14||20||21||23||9||3||12||10||8||6||12||16||7||4||193||1.61||1.63|
|substantial/irreversible bodily impairment||7||9||19||16||16||29||22||11||12||20||24||14||20||14||20||34||287||2.40||2.43|
|can't afford child||176||233||353||384||366||397||205||160||237||361||386||329||299||317||290||263||4,756||39.74||40.27|
|doesn't want child||459||503||547||536||525||576||640||633||588||546||492||487||363||401||393||345||8,034||67.12||68.03|
REASONS GIVEN FOR ABORTIONS: UTAH, 1996-2014 
|% of abortions||% of abortions,|
|maternal life endangered||19||10||5||6||8||6||11||10||12||22||18||22||30||25||16||20||14||8||13||275||0.45||0.45|
Together, the available statistics from these seven states represent 1,929,415 abortions from 1980 to 2014, of which reasons were provided in 1,692,999 cases (this is a sample 124 times larger than the total for the three AGI studies cited above). The definitions and reporting of reasons vary from state to state, and the completeness and accuracy of the reporting has varied over time. Further, it should be noted that these states are not necessarily representative of the nation as a whole; some implications of this are analyzed below.
Federally-funded abortions: Federal Medicaid funds may currently be used to pay for abortions in cases of rape, incest, or threat to the mother's life. This has been the case since 1977, when the Hyde Amendment took effect: federal Medicaid-funded abortions went from about 300,000 per year prior to 1976 to 182,000 in FY 1977, to 232 in FY 1986, and has remained in the hundreds per year through FY 2008 . Some state-level data on these abortions by reason emerged in 2008 in an inquiry from Congress to the Secretary of Health and Human Services regarding a significant increase in such payments in one state.  Specifically, claims from Illinois for abortions in cases of rape increased by a factor of 18 from FY 2005 to FY 2007. Data are shown below:
|state||FY 2005||FY 2006||FY 2007|
FEDERALLY-FUNDED ABORTIONS IN THE CASE OF INCEST 
|state||FY 2005||FY 2006||FY 2007|
FEDERALLY-FUNDED ABORTIONS IN THE CASE OF RISK TO MOTHER'S LIFE 
|state||FY 2005||FY 2006||FY 2007|
In the next table, the figures for abortions in the case of rape in Illinois are adjusted in the same manner as previously applied to state statistics, using an annual figure of 50,000 based on AGI estimates. Assuming that all abortions in cases of rape in Illinois were paid for by federal Medicaid, the FY 2007 figures are compatible with rates of rape-related abortions claimed by AGI, but they are 2-3 times higher than rates supported by analysis of data from other states. More importantly, the dramatic increase from FY 2005 to FY 2007 casts doubt on the reliability of the Illinois figures, suggesting that rape is falsely being claimed as a reason for many of these abortions in order to obtain Medicaid funding (the point raised in the congressional inquiry).
|region||year(s)||abortions where rape is cited||forcible rapes during sample period ||abortions in cases of rape as a percentage of reported rapes||implied U.S. number of abortions in cases of rape in 2005||% of 2005 abortions |
Adjusted figures: Use of these figures to estimate nationwide percentages is affected by differences from state to state. By adjusting the state level percentages for variations in rates of occurrence of rape or variations in the fraction of pregnancies that end in abortion, corresponding nationwide estimates may be derived. The following tables provide estimates of the fraction of abortions in cases of rape, threat to mother's life or health, or fetal health issues, for 2008 (the latest year for which nation-wide abortion figures are available). Estimates are derived from each state-level data set and each AGI survey by applying the derived abortion rates per reported rape or health issue related abortion rates per known pregnancy.
For the case of abortions in cases of rape, adjustment for state-to-state and year-to-year variation in occurrence of rape is necessary. The respective state or survey data set is used to derive the rate at which abortions occur in connection to reported rapes, with these rates then applied to nationwide data to derive corresponding percentage estimates for 2004 and 2011.
|region||year(s)||abortions where rape is cited||forcible rapes during sample period ||abortions in cases of rape as a percentage of reported rapes||implied U.S. number of abortions in cases of rape in 2004||% of 2004 abortions ||implied U.S. number of abortions in cases of rape in 2011||% of 2011 abortions |
|Florida||Jul 2008-Dec 2009||1.85||2,273||8,487||26.78||25,470||2.08||22,540||2.13|
|Minnesota||Oct 1998-Dec 2014||0.62||1,297||32,379||4.01||3,810||0.31||3,370||0.32|
|USA (AGI survey)||1987||1||15,600||91,111||17.11||16,300||1.33||14,400||1.36|
|USA (AGI survey)||2000-2001||0.6||6,100||181,041||8.63||8,200||0.67||7,300||0.69|
|USA (AGI survey)||2004||0.5|
Estimates based on data reported for these six states generally give results significantly below figures based on AGI studies. The sole exception is Florida, which like Illinois as discussed above likely represents inflated reporting of rape as a reason for abortion. For the states of Minnesota, Nebraska, South Dakota, and Utah, the derived national estimates (0.15-0.32%) are consistent despite the larger range in state-level percentages (i.e. factor of 2 range in national estimates versus factor of 4 range in state-level percentages). These estimates are also consistent with the previously derived estimate of 0.54% based on FBI and DOJ figures and the Holmes et al. study. Thus it is reasonable to conclude that, contrary to AGI figures, the fraction of abortions nationwide in cases of rape is closer to 0.3%.
Similarly, if it is assumed that abortions in cases where there are maternal or fetal health problems are a consistent fraction of known pregnancies, the implied nationwide percentages in such cases would be as given below. Note that "known pregnancies" for states includes only pregnancies ending in live births or reported abortions; this excludes miscarriages (small numbers in comparison) and stillbirths (for which little data is available). State-level abortion figures are generally based on state agency reported figures by state of occurrence, while U.S. figures for abortions and pregnancies use AGI abortion figures. Since some states and the AGI surveys do not separate abortions in cases of threat to the mother's life from abortions in cases of threat to the mother's health, these are both included in the maternal health figures below. Figures for threat to the mother's life are then provided separately as available.
|region||year(s)||abortions where mother's health is cited||total known pregancies ||cited abortions as a percentage of known pregnancies||implied U.S. number of abortions in such cases in 2004||% of 2004 abortions ||implied U.S. number of abortions in such cases in 2011||% of 2011 abortions |
|Florida||Jan 1998-Jun 2008||0.51||4,800||3,190,470||0.150||8,030||0.66||7,540||0.71|
|Florida||Jul 2008-Dec 2009||0.22||278||462,150||0.060||3,210||0.26||3,010||0.28|
|Minnesota||Oct 1998-Dec 2014||5.05||10,563||1,340,568||0.788||42,030||3.44||39,490||3.73|
|USA (AGI survey)||1987||3||0.867||46,250||3.78||43,450||4.10|
|USA (AGI survey)||2004||4||0.973||51,900||4.25||48,770||4.61|
ADJUSTED FIGURES FOR ABORTIONS IN THE CASE OF THREAT TO MATERNAL LIFE
|region||year(s)||abortions where risk to mother's life is cited||total known pregancies ||cited abortions as a percentage of known pregnancies||implied U.S. number of abortions in such cases in 2004||% of 2004 abortions ||implied U.S. number of abortions in such cases in 2011||% of 2011 abortions |
|Florida||Jul 2008-Dec 2009||0.06||79||462,150||0.017||910||0.07||860||0.08|
ADJUSTED FIGURES FOR ABORTIONS IN THE CASE OF FETAL HEALTH PROBLEMS
|region||year(s)||% of abortions where fetal health is cited||total known pregancies ||cited abortions as a percentage of known pregnancies||implied U.S. number of abortions in such cases in 2004||% of 2004 abortions ||implied U.S. number of abortions in such cases in 2011||% of 2011 abortions |
|Florida||Jan 1998-Jun 2008||0.56||5,253||3,190,470||0.165||8,780||0.72||8,250||0.78|
|Florida||Jul 2008-Dec 2009||0.64||788||462,150||0.171||9,100||0.74||8,550||0.81|
|Minnesota||Oct 1998-Dec 2014||1.30||2,718||1,340,568||0.203||10,810||0.88||10,160||0.96|
|USA (AGI survey)||1987||3||0.867||46,250||3.78||43,450||4.10|
|USA (AGI survey)||2004||3||0.730||38,940||3.19||36,590||3.46|
Again, the resulting estimates are generally lower than those reported based on the AGI surveys. For cases of risk to the mother's physical health, the state-based estimates vary significantly but are all lower than the AGI-based estimates, and in all but the case of Minnesota are lower by at least a factor of 4. For cases of threat to the mother's life, despite the factor of 7 range in state-level percentages among the three states, the derived national estimates are quite consistent, in the range 0.08-0.13%. For abortions in cases of fetal health issues, the derived national estimates from state data are all lower than the AGI-based estimates by at least a factor of 4.
The following table combines derived estimates of percentages of abortions in cases of threat to the mother's life from the federally funded abortion data and from the state agency data. The federally funded abortion cases are incomplete representations for some states (as this treatment assumes that all abortions in these cases were paid for by federal Medicaid, but likely not all states, and they tend to confirm the low percentages derived from the state agency data-based estimates.
|state||time period||data type||abortions where risk to mother's life is cited||total abortions ||total known pregancies ||cited abortions as a percentage of known pregnancies||implied U.S. number of abortions in such cases in 2008||% of 2008 abortions |
|Alabama||Oct 2004 - Sep 2007||federal||18||0.05||34,160||221,470||0.008||440||0.04|
|Alaska||Oct 2004 - Sep 2007||federal||1||0.02||5,640||37,910||0.003||140||0.01|
|Arizona||Oct 2004 - Sep 2007||federal||1||0.00||32,860||331,850||0.000||20||0.00|
|Delaware||Oct 2004 - Sep 2007||federal||8||0.06||13,810||48,930||0.016||890||0.07|
|Florida||Jul 2008 - Dec 2009||state||79||0.06||122,576||462,150||0.017||930||0.08|
|Georgia||Oct 2004 - Sep 2007||federal||8||0.01||93,740||528,230||0.002||80||0.01|
|Idaho||Oct 2004 - Sep 2007||federal||5||0.14||3,670||75,340||0.007||360||0.03|
|Iowa||Oct 2004 - Sep 2007||federal||4||0.00||134,730||675,400||0.001||30||0.00|
|Illinois||Oct 2004 - Sep 2007||federal||23||0.12||19,100||138,950||0.017||900||0.07|
|Kentucky||Oct 2004 - Sep 2007||federal||1||0.01||11,870||184,610||0.001||30||0.00|
|Maine||Oct 2004 - Sep 2007||federal||20||0.25||7,990||50,370||0.040||2,170||0.18|
|Michigan||Oct 2004 - Sep 2007||federal||3||0.00||75,920||456,100||0.001||40||0.00|
|Minnesota||Oct 2004 - Sep 2007||federal||3||0.01||41,260||258,590||0.001||60||0.00|
|Nebraska||Jan 2000 - Dec 2011||state||50||0.13||38,290||346,504||0.014||790||0.07|
|New Hampshire||Oct 2004 - Sep 2007||federal||3||0.03||9,360||52,600||0.006||310||0.03|
|North Carolina||Oct 2004 - Sep 2007||federal||14||0.01||100,840||479,890||0.003||160||0.01|
|North Dakota||Oct 2004 - Sep 2007||federal||1||0.03||3,790||29,420||0.003||190||0.02|
|Ohio||Oct 2004 - Sep 2007||federal||42||0.04||98,770||547,460||0.008||420||0.03|
|South Carolina||Oct 2004 - Sep 2007||federal||34||0.09||37,300||218,570||0.016||850||0.07|
|South Dakota||Oct 2004 - Sep 2007||federal||1||0.04||2,290||37,760||0.003||140||0.01|
|Texas||Oct 2004 - Sep 2007||federal||25||0.01||239,000||1,423,880||0.002||100||0.01|
|Utah||Jan 1996 - Dec 2010||state||220||0.44||49,963||794,030||0.028||1,510||0.12|
|Virginia||Oct 2004 - Sep 2007||federal||60||0.07||81,170||401,740||0.015||820||0.07|
|Wyoming||Oct 2004 - Sep 2007||federal||2||0.10||2,020||24,520||0.008||450||0.04|
|TOTAL||Oct 2004 - Sep 2007||federal||277||0.02||1,260,119||7,826,274||0.004||190||0.02|
Some states report maternal mental health issues as a reason for abortion. This is a far more subjective determination that the previously reviewed cases, a subjectivity partly illustrated by the case of Utah where 92.5% of abortions from 1996-2014 are reported as "therapeutic". The percentages of abortions reported in cases of maternal mental health issues are: 0.11% in Florida (1998-2008 data), 0.14% in Florida (2008-2009 data), 0.95% in Louisiana (1996-2012 data), 6.46% in Minnesota (1998-2014 data), 7.01% in Nebraska (2000-2014 data), and 8.04% in South Dakota (1999-2014 data).
"Partial-birth abortions" and other late-term abortions: Because of the particularly controversial nature of late-term and "partial-birth abortions" (PBAs), some statistics regarding these abortions has emerged. Partial-birth abortion roughly corresponding to what the medical community describes as intact dilation and extraction. Available data indicates that PBAs are mostly performed for reasons other than for the life or physical health of the mother, reasons including either fetal defects (minor or major) or purely elective reasons.
Kansas requires physicians to report reasons for performing PBAs. Of the 240 PBAs reported in Kansas in 1998 and 1999, there were none where the mother's life was at risk; in every case the attending physician certified "that continuing the pregnancy will constitute a substantial and irreversible impairment of the patient's mental function" and that there was not a substantial physical risk to the mother from the pregnancy. No PBAs have been reported since 1999 in Kansas, but other abortions performed at 22 weeks gestation or later must similarly be reported. For these as well, few if any are cited as involving risk to the mother's life; typically, risk to the mother of "substantial and irreversible impairment of a major bodily function" is cited.
Physicians who perform large numbers of PBAs have stated that many are performed for elective reasons. In an interview with American Medical News, M. Haskell stated that about 80% of the PBAs he performed were purely elective, with the remainder performed for genetic reasons.[33, 34, 35, 36] In testimony to Congress, J. McMahon reported that for about 2,000-2,100 PBAs he had performed, 1,183 (56%) were for fetal "flaws" or "indicators", 175 (9%) were for maternal "indicators", and the remainder (about 700, or 35%) were elective.[34, 35, 37] McMahon further indicated that elective abortions comprised 20% of those he performed after 21 weeks gestation, and none of those he performed after 26 weeks.
McMahon's 1995 testimony to the House Judiciary Committee gave more detailed statistics, which have been analyzed by physicians P. Smith and K. Dowling. Among maternal indicators, the single most frequent was maternal depression (39, or 1.9% of total), with 28 attributed to maternal health conditions "consistent with the birth of a normal child (e.g. sickle cell trait, prolapsed uterus, small pelvis)" (1.3% of total) and the remainder (5% of total) for other maternal factors ranging from maternal health risk to "spousal drug exposure" and "substance abuse". Those performed for fetal indicators included some for lesser conditions such as 9 (0.4% of total) for cleft lip-palate, 24 (1.1% of total) for cystic hydroma, and other for conditions either surgically correctable or involving lesser degrees of neurologic/mental impairment.[35, 36]
Estimates of the annual numbers of PBAs in the United States range from 2,200 to 5,000, with documented annual numbers between 1996 and 2005 ranging from 76 to 1,642.
Summary and conclusions: Based on the preceding analyses, the following composite estimated percentages are suggested (with parenthetical values giving the ranges of values from the above studies and analyses):
|rape||0.3 % (0.1-0.6 %)|
|incest||0.03 % (0.01-0.1 %)|
|physical life of mother||0.1 % (0.01-0.2 %)|
|physical health of mother||0.8 % (0.1-3 %)|
|fetal health||0.5 % (0.1-1.0 %)|
|mental health of mother||?? (0.1-8 %)|
--too young/immature/not ready for responsibility
--to avoid adjusting life
--mother single or in poor relationship
--enough children already
|98.3% (87-99 %)
--? (32 %)
--30% (25-40 %)
--? (16 %)
--? (12-13 %)
--? (4-8 %)
--0.1% (<0.1-? %)
--0.1% (<0.1-0.4 %)
Note that quantifying cases involving the "mental health" of the mother is difficult due to the highly subjective use of this term (as demonstrated by the wide range in percentage of abortions reported for this reason). It is likely that the number of cases involving clinical mental illness falls towards the low end of the range given above.
These official state statistics suggest that the commonly cited AGI figures for the "hard cases" are high, perhaps by factors of three to five. In any case, it is clear that the hard cases--rape, incest, life/health of mother or baby--are a very small fraction of cases. They are arguably a poor premise for formulating general public policy regarding abortion. At the other extreme, AGI's surveys of 1987 and 2004 (as well as the detailed statistics from Minnesota) suggest that a significant fraction of abortions are obtained by mothers who have the means to care for a child but do not want their lives inconvenienced. Even sex selective abortions may be more common than those for some of the hard cases. This illustrates the consequences of the current extreme policy in the United States regarding abortion.
© 2003, 2005, 2006, 2008, 2012, 2016 by Wm. Robert Johnston.
Last modified 18 January 2016.
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